ALIDA ANNE DEJONG


Address: 1045 James St, Syracuse, NY 13203-2730
Phone: 3154724471

ALIDA ANNE DEJONG (NPI# 1013912153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013912153
Entity Type Individual
Full Name ALIDA ANNE DEJONG
Other Name ALIDA ANNE KIMMELMAN
Credential NP
Practice Address 1045 James St
Syracuse
NY 13203-2730
Practice Telephone 3154724471
Practice Fax Number 3154721759
Mailing Telephone 3154724471
Mailing Fax Number 3154721759
Enumeration Date 2005-06-16
Last Update Date 2015-12-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WG0000X Registered Nurse
Specialization: General Practice
482368-1 NY Nursing Service Providers
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
F302146-1 NY Physician Assistants & Advanced Practice Nursing Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
F333173-1 NY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 02629216 05

Office Location

Street Address 1045 JAMES ST
City SYRACUSE
State NY
Zip Code 13203-2730

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326648395 Liberty Resources Psychology, Physical, Occupational and Speech Therap Early Intervention Provider Agency 1045 James St, Syracuse, NY 13203-2730 2020-10-29
1083211619 Tracy L. Eckstrand Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-10-06
1306458070 Amy Marie Ruetsch Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-08-23
1891306742 Nichole Dawn Slate Social Worker 1045 James St, Syracuse, NY 13203-2730 2020-08-13
1245849280 Louis Shirley Peer Specialist 1045 James St, Syracuse, NY 13203-2730 2020-07-27
1083232367 Melissa Louise Potter Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-07-13
1881221885 Kirsten Melville Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-03-27
1699302380 Jennifer Breau Counselor 1045 James St, Syracuse, NY 13203-2730 2020-03-24
1679109771 Lora M Denero Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-03-20
1437784881 Robin Lee Pierce Developmental Therapist 1045 James St, Syracuse, NY 13203-2730 2020-03-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659998193 Allison Elizabeth Mills Social Worker 1045 James St., Syracuse, NY 13203 2020-07-01
1467004333 Humanitarian Organization for Multicultural Experiences, Inc. Psychologist 831 James Street, Syracuse, NY 13203 2019-07-11
1215405287 Wellness Therapy Services Lcsw, Pllc Counselor Wellness Therapy Services Lcsw, Pllc, 404 Oak St. #200, Syracuse, NY 13203 2018-11-08
1962904912 Michael Musante Developmental Therapist 1045 James Streret, Syracuse, NY 13203 2018-03-06
1811410236 Lindsey Deborah Sanborn Nurse Practitioner 301 Prospect Avenue St. Josephs's Hospital Health Cente, Syracuse, NY 13203 2017-07-18
1497205975 Phuong Pham Counselor 329 North Salina Street, Syracuse, NY 13203 2016-10-10
1942754015 Shelly Lynn Peters Nurse Practitioner 329 N. Salina Street, Helio Health, Syracuse, NY 13203 2016-08-06
1932574217 Kaleigh Marie Andino Audiologist 1001 James Street, Syracuse, NY 13203 2015-12-11
1376889493 Brenda S Hartman-souder Social Worker 526 Oak St., Syracuse, NY 13203 2012-12-18
1386914711 Steven W Dimarzo Counselor 404 Oak St Ste 320, Syracuse, NY 13203 2012-01-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437750171 Dana Alberico Lonis Nurse Practitioner 246 Waldorf Pkwy, Syracuse, NY 13224-2118 2020-11-07
1679191019 Katherine Rose Halleck Nurse Practitioner 141 Atkinson Ave, Syracuse, NY 13207-1125 2020-07-13
1649817693 Ladislava Kulikova Nurse Practitioner 55 Westbrook Hills Dr, Syracuse, NY 13215-1809 2019-12-09
1841845799 Robin M Stark Nurse Practitioner 1000 E Genesee St Ste 402, Syracuse, NY 13210-1853 2019-08-07
1699335729 Kathleen M Tindall Nurse Practitioner 739 Irving Ave Ste 450, Syracuse, NY 13210-1663 2019-06-20
1760964142 Stacey Margaret Schneble Nurse Practitioner 114 Skyview Ter, Syracuse, NY 13219-2850 2018-09-03
1447753355 Lilia P Buchmuller Nurse Practitioner 1361 S 2675 W, Syracuse, UT 84075-8306 2018-03-16
1366967366 Zakiya Folami Moss Nurse Practitioner 321 Gifford Street, Syracuse, NY 13204 2017-08-10
1811410236 Lindsey Deborah Sanborn Nurse Practitioner 301 Prospect Avenue St. Josephs's Hospital Health Cente, Syracuse, NY 13203 2017-07-18
1225550783 Kerry Laine Goessling Nurse Practitioner 6712 Brooklawn Pkwy Ste 204, Syracuse, NY 13211-2158 2017-07-16
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Competitor

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City SYRACUSE
Zip Code 13203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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